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Case Report
Dementia and Neurocognitive Disorders 2016: 15: 3: 88-91

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Human Herpes Virus 6 Encephalitis Following Bone Marrow Transplantation with Uncommon Magnetic Resonance Imaging Findings
Jihye Hwang, Ji Eun Kim, Jee Hoon Roh, Jae-Hong Lee
Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Human Herpes Virus 6 Encephalitis Following Bone Marrow Transplantation with Uncommon Magnetic Resonance Imaging Findings
Jihye Hwang, Ji Eun Kim, Jee Hoon Roh, Jae-Hong Lee
Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Background Human Herpes Virus 6 (HHV6) is commonly associated with encephalitis following bone marrow transplantation. However,
hippocampal atrophy and global hypometabolism are rare findings in HHV6 encephalitis.
Case Report A 41-year-old right-handed woman with acute lymphoblastic leukemia presented with fever and mental changes 2 weeks after
receiving a sibling bone marrow transplant. The patient’s cerebrospinal fluid (CSF) was positive for HHV-6 deoxyribonucleic acid (DNA),
but was negative for other viral DNA. Brain magnetic resonance imaging revealed atrophic changes in bilateral medial temporal lobes. Following
4 weeks of ganciclovir therapy, a CSF exam was negative for HHV-6 DNA and the patient’s neurological symptoms partially improved.
However, she was disoriented and had severe retrograde and anterograde amnesia. 18F-fluorodeoxyglucose-positron emission tomography
indicated global hypometabolism in the medial temporal lobes and the fronto-parietal cortices.
Conclusions This is a rare and unusual case of hippocampal atrophy in the acute stage of HHV6 encephalitis. Our imaging findings may
reflect the chronic indolent course of HHV6 encephalitis.
Key Words: herpes, human herpes virus, Human Herpes Virus 6 encephalitis, limbic encephalitis, retrograde amnesia, anterograde amnesia.
대한치매학회지 (Dementia and Neurocognitive Disorders)